Home Forums Discussions General Discussion Complete Paperless?

Is anyone here trying to move to completely paperless office? I started my practice only 15 months ago so I have been on EMR since the beginning, but trying to see what people are doing about the normal intake forms from the patient.

Or do you have staff just ask the patients and input it into the AC?

I am using phreesia now but phreesia really takes a long time and the pad is a nusance, however it is awesome for the hippa form signature and for the demographic information for my billing person to securely access online.

I have thought about Instant medical history which is great cause patients can do the stuff at home online or in the office if i provide them with a little netbook, but there is no demographic info that is saved on a server somewhere for my biller to access.

Thoughts? Help?

Have you considered giving you biller access to Amazing Charts?

Yes I have and that isn't an issue for her to log into the server, however the nice thing about Phreesia is that it also automatically keeps track of who came in what day as well.

I can give up phreesia if that is the only way to go. I was thinking about having them review all the info in phreesia when they came in and hit no changes (it shows up all on one page) and then sign the hipaa form and then do the instant medical history.

but my brother pointed out last night that that is making it harder on the patient

Hi Sports Doc
I tried being completely paperless at first and had to move to having an encounter form on a clipboard. Phreesia was not helpful with my older population, although I have heard some practices really get help with it.
We actually have 2 pages, one that is a triage sheet that the vitals are recorded on. They write the weight on the form so it is there when they get to the room and put it in AC. They then write the rest of the vitals on the clipboard and on the chart. It has insurance info and other info that I need for my diabetics and folks on long term anticoagulation.
The other page is for the clinical staff to write down their charges/codes-labs, injections, etc.
If there have been labs that have been done we have one printed copy that goes on the clipboard. I go over it with them and then give them the copy.
Most our of our labs come by interface, but the labcorp computer spits out a copy that we save. The rest of the labs, xrays and other stuff all come via updox. The front office prints them for my review and then we save them in a vertical a-z file until their visit. The clerk also efiles the updox labs, xrays etc to the patient chart. No more printing, rescanning, etc. Has saved us hours!!
You'll find what works for you. Hang in there.

I've thought about it long and hard and completely paperless is still a pain. Now, all of the info that we make the patient sign/fill-out such as HIPAA, demographics, medical history, etc is all either entered or imported so there is no paper chart. But completely paperless is tough.

New patients have a paper history form, and sign the Hippa forms.

Established patients just have a paper superbill on a clipboard with the vitals written on it and all pertinent info I need on it (i.e. date of surgery, referring provider, whatever).

My older patients would never use the internet to enter health info. Medicaid patients probably wouldn't either.

Sometimes a little paper is o.k.

Phreesia took too much time and was no help.

I would say we have gone paperless in one office and are getting there in the other one.

We scan new patient registration information (and old patient update and developmental sheets) as soon as they come in and shred that, we do not use an electronic tablet. (So does that mean we aren't really paperless?) We do not make charts for new patients. We are in the process of scanning old charts when the patient is seen and more.

Faxes come in through the Brother fax and never go to paper. Most simple forms I write up in Paperport, but sometimes a complex form is easier to do in paper and I will occasionally print one out.

I will occasionally scribble notes to the MA about shots or labs on exam paper or scraps (that doesn't count, we don't have to get rid of exam paper do we )

I don't use orders to send them information, it is too clunky (they have to update their inbox, ect., it's a small office, a lot easier to talk to the staff, imagine that!)

Billing is done through AC and MTBC (don't get me started) and no paper superbill is created.

We do still give paper information handouts to patients.

However, we have cut paper use tremendously.

I started writing this by saying we had gone paperless, which functionally I feel we have. But then there are these caveats.

I will agree with Travis, "sometimes a little paper is O.K."

I concur. Sometimes paper is just much more efficient.

It's paper that holds the joint together

I read once that if you go to any EMR office that talks about paperless, you will see that THEY are NOT paperless, lol.

Yes, despite the bad economy we haven't considered getting rid of the toilet paper

Does "MTBC" stand for "My Terrible Billing Company"? Or am I totally off base on that?

First off, thank you for a few laughs along this thread so far. Yes some paper is okay, I guess I meant to get rid of paper history forms and also to not have to hold onto hippa forms that patients sign. I think in the end for me, getting a tablet to have them sign and upload a document is bettter then holdin a paper form. Maybe for me, it is because I have only one staff member, so the more we can automize things the better. If i had more manpower maybe I would go with a little more paper.

HIPPA was passed in 1996. Has anyone EVER had to produce a HIPPA form for anyone at anytime? Have you ever heard of anyone having to produce a form?
I am not saying that we don't need to keep doing this, but.....

No but I have had to add a form to my practice as I do sports medicine. I have a form now that says that if you were either referred by an athletic trainer/physical therapist at the gym/club you are at then you give me permission to talk to that person about what is going on.

STORY TIME: I had a 12 year old girl come to my office. She was a cheerleader (dolled up like she was 18 and overmade up by her mom who looked like a former prom queen missing her days in HS) and injured her knee two weeks before she saw me. Was called by an athletic trainer who works at the gym saying that tonight (it was 10 pm) she saw the girl without tights on and her leg is black and blue from the knee down and swollen like crazy). I say okay see her tomororw. mom brings her in and it is obvious there is somethign major wrong. bottom line: kid has a growth plate fracture with displacement so needs crutches and ct scan and follow up with surgeon...i calll the athletic trainer and let her know that i told the kid not to do anything so protect her from the coaches cuase coaches are nuts. mom and dad come in the following day for CT scan results without duaghter adn i tell them what is wrong and they bitch me out for 45 mins telling me i violagted hippa by telling the athletci trainer that she can't play..mind you i iddn't give the diagnosis. . .in the sports medicine world this is standard of care.. in the end i told the parents here is a note to get her out of PE and cheerleading and she needs to see surgeon. . .they look at me and say " she has a competition tomorrow, we are the parents we will decide if she can participate or not". they reported me to the illinois department of federal regulation for violation. . .

i was investigated and had everything documented so everything was cleared...but BOTTOM LINE: IT ONLY TAKES ONE!

so needless to say, i have an extra form now that says hey i can talk to the PT, ATC whatever. And they can decline that option too.

Ketan,
I would like to say that I amazed, but I am not. After the parents left did you call Protective Services?

Indeed, it sounds like THEY are the ones that need to be reported.

I certainly would have called Child Protective Services. The injury is quite suspicious as is the parents behavior

Lois

Ketan,
I have been through one of those similar board of medicine investigations before(I prevailed). It probably cost my malpractice insurance company $10-20 thousand to defend me. What a waste of money.

As far as your case, after your ordeal, you know, but hippa privacy does not apply to T.P.O. (treatment, payment, operations).

Obviously your contacting the trainer is good faith, in the interest of the patient, and ethically correct in terms of treatment.

No good deed goes unpunished, as they say.

I am with Jon. I couldn't care less about HIPAA forms.

You should definitely report them. Bet that wont be a hippa violation.